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may result in forfeiture of contractual payments. <br />I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid <br />for public works are true and correct. <br />Dated this _ m 9th day of August2019 <br />C&S Masonry/ -Restoration Lc_.___.. <br />Contractor/Bidder (;Fltni) <br />Signature of Contractor/Bidder or Its Agent <br />Steve Fields / President_.. _.. <br />Printed Name and Title <br />Subscribed and sworn to before me this L day of4, 2(I <br />My Commission Expires <br />Notary Public <br />County of Residence �........ <br />MARSHA L. BROWN <br />Notary Public, state of Indiana <br />nunty of St Joseph <br />SEAL <br />Corn mission # 644174 <br />COmFwNUdW60 Y'a. I aXPIr•ra■ JyUMO ",2022 <br />Version 4/2/2019 Contractor's Bid for Public Works - 7 <br />